Papillary Endothelial Hyperplasia of the Adrenal Gland: A Case Report and Review of the Literature

Abstract Adrenal cysts are becoming more commonly identified because of advances in imaging techniques. The differential diagnosis of adrenal cysts is broad, and an uncommon finding in the cyst is papillary endothelial hyperplasia (PEH). Papillary endothelial hyperplasia is a benign endothelial proliferation which is most commonly described in the skin, and is uncommonly seen in visceral organs. We report a case of a 36 year old woman who presented with abdominal pain and subsequent imaging revealed an adrenal cyst. The patient then underwent surgery with removal of a 3.6 cm cystic adrenal gland. Histologic examination revealed numerous papillary structures covered by benign endothelial cells (CD34, CD31, ERG positive) consistent with PEH. Given the rarity of PEH as the predominant finding in the adrenal gland, recognition of PEH as a benign entity is important. In this report we present our case in the context of the literature and review differential diagnosis of PEH in the adrenal gland.